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Tuesday 20 November 2012

The hormone that makes you fat By OLIVIA GORDON


The simple temperature test that could stop all the misery


Stepping on the scales, I gasped in shock. I weighed 12st - yet ten days earlier I had been 11st, and five weeks before that I was 9st. I had gained 3st in just over a month.

But my diet and activity levels hadn't changed - so the dramatic weight gain was inexplicable. I was 21, in my first term as a mature student at Brighton University, and over the previous few months, my whole body had seemed to go haywire.

Although my ballooning size was the most obvious change, I had other problems: my head felt full of cotton wool, I was exhausted, slurring my words and barely able to summon the energy to walk.

My hands and feet were oddly numb. I couldn't concentrate and my studies slipped. I had already been through a traumatic year. The previous Christmas, when I was 20, my boyfriend of four years, Paul, and our best friend, Jake, had been killed in a motorbike accident.
They had gone on holiday to Spain and one night I received a call telling me they had crashed after a night out and been killed outright.

Before Paul?s death, I had dropped out of my degree in Business Studies and started modelling clothes and working in bars and clubs in Brighton.
I?d never been under pressure to lose weight as a model, but after Paul?s death I lost my appetite.
Lonely, and realising life was short and I should make the most of it, I started going all-night clubbing and didn?t pay much attention to eating properly, so my body wasn?t in its healthiest state. I went off the rails.

One night, my heart started to pound. I couldn?t breathe and thought I was going to die. My friends took me to casualty, where doctors said I was having a panic attack.
I sat on the bed in hospital and caught sight of myself in a mirror. My neck was all swollen, but I was told it was fine and I was discharged.

I started having palpitations and panic attacks a couple of times a week and knew something was really wrong. At first I thought it was caused by the trauma of Paul?s death and I would just have to live with it.

Then I started sleeping the sleep of the dead ? I would lie down for a nap and wake up groggy 12 hours later, then pass out again.

But having been dismissed by the hospital, I didn't seek any further medical help and that September I went back to Brighton University to start a new degree in the History of Design, hopeful for a fresh start.

Yet here I was, halfway through the first term of my new degree course, suddenly four dress sizes bigger and feeling shattered and scared.

I was no longer the lively Chessy everyone knew: I had lost my confidence to the extent I could hardly go out. My friends and family were very worried about me.

My parents live in Malaga, Spain, and the last time they'd seen me was before I left for university. I was a size 8-10 and fit as usual, but that Christmas I came back a size 16 and three stone heavier and they were shocked to see me.

Mum later told me how we were eating dinner together one night when she saw my eyes glaze over. I sat with my fork in the air, staring into space. She said it looked as if my batteries had run down.

My parents believed me when I said I had an illness, but it was hard for them to be sure without a diagnosis - even I doubted I was ill sometimes.

I went to my GP, who did a blood test and told me there was nothing the matter with me. But I felt something was seriously wrong and saw a string of other doctors.
They all said I just needed to go on a diet and do some exercise. I cried, explaining that I wasn?t eating too much, but no one believed me.

I started to doubt myself, and did as the doctors suggested, going for a run on Brighton seafront. I managed about two minutes before I was too shattered to go on.
My size also meant I couldn?t apply for modelling jobs any more and my voice had got deeper, which meant my hopes of a singing career were also dashed.

I couldn?t fit into any of my clothes, and when my friends appeared shocked to see the new me, although I could understand their surprise, it really hurt my feelings.I just wanted to explain to everyone that I really was sick, and miserable.

I struggled on, until finally, at the end of the first year on my new degree, I was referred to a consultant. This time, my thyroid problem showed up in a blood test.

I have subsequently found out that because the range of readings for borderline patients is so wide, it is very much up to an individual doctor to make a definite diagnosis.
All my symptoms over the last year suddenly made sense. The thyroid gland regulates every metabolic process in your body, so with an under-active thyroid your body slows down - slow digestion and energy-burning leads to weight gain.

Vision, hearing, speech and mental processing abilities all wind down like clocks. Often thyroid problems run in families, but there is no history of it in mine.
My consultant explained that my thyroid could have been unbalanced by a traumatic event like the death of my boyfriend.

I also believe my unhealthy diet could have contributed to my illness, since that, as well as stress, is another known trigger.

I was prescribed hormone replacement medication, Thyroxine, to keep my thyroid ticking over. Sadly, there is no cure for an under-active thyroid and I will always have to take the medication, but I haven?t suffered any side-effects.

I understand that there are few problems if you take it long term - because it mimics the body?s own natural hormone. It took several months to start feeling better.

My mind got its sharpness back, my weight rebalanced at 11st and my panic attacks subsided. My neck is still swollen even after treatment, so my singing voice hasn?t come back, but I graduated from university, worked as a music and events producer, and then retrained as a journalist.

This year I started a fantastic job as a presenter on the radio station Talk Sport, where I can use my husky voice to my advantage!

Only now, ten years since I started treatment, am I finally getting back to health. I?ve been taking Thyroxine all this time and have to increase my dose every few years as my thyroid keeps slowing down.

I still have weeks when I feel tired and gain weight, and then I see my doctor and raise my dosage. I started on a low dosage and am still on a relatively moderate amount.
I've got my weight down to 9st 7lb, but I have to put a lot more care into my diet and exercise than most people.

It breaks my heart to think that someone may be going through what I did, just because some simple tests have not been tried, so I am supporting a campaign by Thyroid UK for doctors to use alternative tests, including checking urine and saliva.

Had someone recognised my symptoms rather than relying on inconclusive blood tests, it would have saved me years of illness.

There must be other people out there who are sick, tired and overweight, yet are being told by their doctors there is nothing wrong with them.

My advice, if you do notice any of the symptoms that I had, is to ask for a thyroid test. If it isn?t conclusive and you still feel ill, don?t give up.

Don?t think you are going mad, explore every avenue to get a diagnosis.

A SIMPLE TEMPERATURE TEST COULD STOP ALL THE SUFFERING
The thyroid gland, located in the neck, is part of the body?s endocrine system, which also includes the pituitary and adrenal glands, the pancreas and the testes.

This system regulates the body's hormones, controlling everything from growth to sex to (in the thyroid?s case) metabolism.

Hypothyroidism - or an underactive thyroid - produces a number of symptoms, the most common being weight gain, tiredness, hair loss, dry skin and lack of concentration.
Typically, weight gain is gradual, taking place over months or even years and sufferers find it difficult to shed weight by dieting.

The thyroid gland lies just below the Adam?s apple and secretes two hormones - thyroxine and triiodothyronine.

The first is called T4 and in the cells it is converted into the second hormone, T3.
It is T3, the active thyroid hormone, which is all-important and influences the speed with which cells work.

It regulates appetite, the glossiness of hair, whether the skin is dry or moist and above all, mental, physical and emotional energy. Too little and the body slows right down.

You?ll get depressed, moody and exhausted, have problems with your memory, put on weight, and lose hair. Constipation and a croaky voice are also signs of hypothyroidism.

Thyroid problems are diagnosed by a simple blood test which measures the level of TSH (thyroid stimulating hormone). The TSH test measures T4 on a scale of around 0.4 to 4 or 5.
Above 5, you will be diagnosed as having an underactive thyroid and will be prescribed thyroxine, a synthetic T4, which is taken in tablet form daily.

"It?s a very robust test," says Dr Mark Vanderpump, a consultant endocrinologist at the Royal Free Hospital, London. "If someone says they have an underactive thyroid and their TSH test is normal, then they haven't."

But this is where the debate starts. Some patient support groups and private practitioners argue that if someone has a reading between 2 and 4, then their thyroid is abnormal and such a patient would benefit from treatment.

They also argue that other diagnostic tests should be used in conjunction with the blood test - including, for instance, a temperature test, because low body temperatures can also be a symptom of an underactive thyroid.

Many doctors are reluctant to do this however, because thyroxine is a treatment for life and as such is expensive, particularly if it is not clear-cut whether the patient actually needs it.
A small amount of thyroxine will do no harm, they say, but if you give patients more than they need, there is a risk they may develop an abnormal heart rhythm and the bone-thinning disease, osteoporosis.

Thyroid UK, the support group set up in 1999, to increase awareness of the condition, is convinced that thyroid problems among young women are on the increase.

Its founder, Lyn Mynott, believes thousands of people, mainly women, are suffering from hypothyroidism - but are not getting adequate treatment.
Stress, a diet lacking in iron and fresh fruit and vegetables, and pollutants are the chief culprits, she says.

Dr Georges Mouton, a GP in Wimbledon with private clinics in Harley Street and Madrid, maintains that many of the major pollutants, such as dioxins and insecticides are well-known thyroid aggressors.

However, most doctors dismiss the connection with diet or pollutants and believe that it is simply convenient to use thyroid problems to explain away unwanted weight gain, depression or stress.

Moreover, some endocrinologists say that there is no evidence that hypothyroidism is on the increase - it?s just that people are having more blood tests, more abnormalities are being spotted and more people are blaming the thyroid.

According to Dr Prakash Abraham, consultant endocrinologist at Aberdeen Royal Infirmary: "It?s a fairly common condition. Doctors are checking it more, but there is nothing to suggest it is increasing."

Dr Colin Dayan, consultant endocrinologist at Bristol Royal Infirmary, says that around 5 to 10 per cent of women have an abnormal thyroid blood test, but it?s usually only very slightly abnormal and studies show that they would gain no benefit from taking thyroxine.
He stresses that only 1 in 100 have symptoms of hypothyroidism that affects their lives to the extent that they need treatment. 

BARBARA ROWLANDS.
Thyroid UK: www.thyroiduk.org British Thyroid Foundation: 01423 709 707; www.btf-thyroid.org


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